Diagnostic value of the soluble triggering receptor expressed on myeloid cells-1 in bacterial infection: a meta-analysis.
OBJECTIVE
To evaluate the accuracy of the soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) as a diagnostic test for bacterial infection.


METHODS
Meta-analysis of 13 diagnostic studies.


METHODS
Medline; Embase; Web of Science (from January 1966 to January, update to August 2008); and Cochrane Controlled Clinical Trials Register Database (through first quarter 2008).


RESULTS
A meta-analysis of all 73 studies was performed. Thirteen studies fulfilled the inclusion criteria (980 patients, 557 patients with bacterial infection, 423 with non-bacterial infection); global prevalence was 56.8%. The global sensitivity was 0.82 (95% confidence interval CI, 0.68-0.90), the specificity was 0.86 (95% CI, 0.77-0.91), the positive likelihood ratio (PLR) was 5.66 (95% CI, 3.41-9.38), the negative likelihood ratio (NLR) was 0.21 (95% CI, 0.12-0.40), and the diagnostic odds ratio (DOR) was 26.35 (95% CI, 10.32-67.28). The area under the curve of the summary receiver operator characteristic (SROC) was 0.86 (95% CI, 0.77-0.91), with a Q point value of 0.84. The sensitivity of the sTREM-1 assay for diagnosis of urinary tract infection was low (0.18, 95% CI, 0.05-0.51).


CONCLUSIONS
sTREM-1 represents a reliable biological marker of bacterial infection, but it may be not a sufficient biological marker for infection of the urinary tract as a result of its low sensitivity. Whether sTREM-1 guidance can reduce antibiotic use as well as the measurement of sTREM-1 in different types of infection will require additional prospective studies.
Jiyong
Jing
J
Intensive Care Unit, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China. Jiyong_jing@hotmail.com
Tiancha
Huang
H
Wei
Cui
C
Huahao
Shen
S
D001424:Bacterial Infections / Q000235:genetics*; D015415:Biomarkers; D006801:Humans; D008562:Membrane Glycoproteins / Q000235:genetics*; D025202:Molecular Diagnostic Techniques / Q000379:methods; D011971:Receptors, Immunologic / Q000235:genetics*; D012042:Registries; D000073871:Triggering Receptor Expressed on Myeloid Cells-1
D015415:Biomarkers; D008562:Membrane Glycoproteins; D011971:Receptors, Immunologic; C408842:TREM1 protein, human; D000073871:Triggering Receptor Expressed on Myeloid Cells-1